Employee Wellness Plans : Blood Pressure Measurement and Education

Appropriate medical care or allied health professional trained in measurement of Blood Pressure, referral protocols, and delivering educational messages to colleague delivering Blood Pressure programs. These programs are necessitated to follow national ground rules.

• National ground rules for Blood Pressure (BP) protocols:
   o Calibration of Blood Pressure (BP) measuring equipment
   be done at least each year.
   o Two or more measurements of colleague’s Blood Pressure should be taken.
   o Referral of participants with elevated Blood Pressure (BP) readings to personal physician for further evaluation.

• Systolic/Diastolic Follow-Up:
   o Normal:   <130 / <85
      Action: Recheck in 2 years
   o High Normal:   130-139 / 85-90
      Action: Recheck in 1 year

• Hypertension:
   o Stage 1 (Mild):   140-159 / 90-99
      Action: Confirm within 2 Months.
   o Stage 2 (Moderate):   160-179 / 100-109
      Action: Refer to source of care within 1 month.
   o Stage 3 (Severe):   180-209 / 110-119
      Action: Refer to source of care within 1 week.
   o Stage 4 (Very Severe):   >210 / >120
      Action: Refer to source of care immediately.

• Appropriate educational messages:
   o Normal:   <130 systolic and <85 diastolic
      Action: No referral. If on treatment, then inform attendant that Blood Pressure is under good control today and ought to continue seeing and following treatment program.
   o High Normal:   130-139 systolic and/or 85-89 diastolic
      Action: Recommend that colleague have Blood Pressure (BP) rechecked within 1 year unless under treatment. Advise colleague that the readings are in a high normal range that needs rechecking. In the interim, suggest that one of the most effective means to lower Blood Pressure (BP) is to bring weight into normal range and to exercise.
   o High:   >140 systolic and/or >90 diastolic
      Action: Refer to physician for further evaluation within 2 months unless the level is within urgent, emergency, or isolated systolic hypertension levels. If already on treatment, advise attendant of readings and need to get Blood Pressure (BP) to a intention of 140/90 or less.
   o Isolated Systolic Hypertension:   140-159 systolic and < 90 diastolic in a colleague 65 years of age or older.
      Action: Advise colleague to inform physician of readings at next visit and consider advice regarding weight loss and exercise if appropriate.
   o Urgent:   180-209 systolic and/or 110-119 diastolic
      Action: Recommend obtaining medical assessment within 1 week.
   o Emergency:   >210 systolic and/or >120 diastolic
      Action: Obtain immediate medical care attention.

• Provides the following:
   o Written results, referral guidelines, and an explanation of Blood Pressure levels given to each attendant with individualized counseling, including advice about the interval of time recommended when the attendant should be checked again.
   o Utilizes the recommendations in The Fifth Report Of The Joint National Committee on Detection, Assessment and Treatment of High Blood Pressure, March 1994.
   o Written and audiovisual materials that are informative, easy to understand, and useful while containing scientifically accurate information.
   o Relationship of elevated Blood Pressure and other risk factors, such as family history, smoking, high fat and unhealthy diet, lack of exercise, in the development of cardiovascular disease, including stroke, kidney disease, heart attack, and other diseases.
   o Definition and causes of elevated Blood Pressure.
   o Importance of following prescribed treatment.